Detailed guides to painful problems, treatments & more

The remove-or-improve project: 2 major article upgrades so far

 •  • by Paul Ingraham
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Weekly nuggets of pain science news and insight, usually 100-300 words, with the occasional longer post. The blog is the “director’s commentary” on the core content of a library of major articles and books about common painful problems and popular treatments. See the blog archives or updates for the whole site.

The year 2021 is off to an unusually busy start for me with a major initiative to improve pull-up the average quality of the content in the library. Lots of my articles are in great shape, best-in-class articles that have been regularly updated and upgraded for well over a decade — polished to a high shine. But some content has fallen through the cracks. I refuse to be more specific on the grounds that it may incriminate me, so let’s just say that there were “a number” of older, staler, weaker pages piling up.

But not any more.

For each page on the site, I asked the question: “Remove it? Or improve it?” And I removed a couple dozen, and now I’m thoroughly upgrading the most needful of those that remain.

Updates have always been a major feature of, but my approach has always been to spend a 2–4 hours on each update, moving constantly from topic to topic. You can get a lot done that way over time, and I have, but a good upgrade just takes more time — a lot more. For this project, I will be spending 2–4 days on each update, long enough to really wrap my head around it, and make the kind of improvements that just aren’t feasible with just a few hours of work. Two articles have gotten the reboot treatment so far:

  • Tennis Elbow Guide — Not just for tennis players! A detailed, science-based tour of the nature of the beast and reviews of all the treatment options.

    For almost 15 years, this article has been a bit neglected, one of the weaker pages on Finally I can honestly claim it is strongly competitive with any other information you can find on this topic. When I began, I felt a little bored with the subject, and wasn’t sure how I was going to spend days on it. But within a few hours, the usual thing happened: a “simple” musculoskeletal medicine problem proved to be rotten with rabbit holes, and by the time I was done I felt frustrated that I couldn’t afford to spend another seven days. Here are five weird things about tennis elbow, five reasons I got hooked:

    1. It may often be more about muscle than tendon — an unusually muscle-y tendinitis.
    2. Even if it is a proper tendinitis, it’s not a tendinitis of just one tendon, but a whole cluster of them.
    3. It has less to do with elbow strain than anyone thinks, and probably much more to do with systemic vulnerability than anyone thinks.
    4. Tennis elbow can be a symptom or complication of neck problems.
    5. Psychological factors actually matter, especially in chronic cases.
  • The Dubious Science of Kinesiology Tape — The origin story and science of therapy tapes like Kinesio Tape, KT Tape, Spider-Tech, RockTape

    There’s a lot of competition for this topic in Google search, a popular topic ever since the 2012 Olympics. Before this upgrade, it was just a token position piece, my opinion of therapy taping in a nutshell, generally debunking it, indistinguishable from about a thousand other blog posts out there. After the upgrade, it’s a beast of an article, much more thorough and crafted than anything other source I’m aware of. And, once again, the topic turned out to be surprisingly interesting, full of unexpected twists and turns.

Just two? Unfortunately, that’s all for now! Several weeks back, I swept many other priorities aside for this remove-or-improve project, making it my only major priority… which was just asking for a bigger priority to come along, and so it did. It got pre-empted by even more urgent business: an important, time-sensitive opportunity to upgrade my online store. More on that coming soon. Meanwhile, blogging will be a bit light for a while: even when I do get back to content, I’ll be up to eyeballs in updates for days at a time.

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